氯吡格雷抵抗对老年急性冠状动脉综合征患者冠状动脉介入治疗预后的影响  

Effect of Clopidogrel Resistance on Prognosis of Elderly Patients with Acute Coronary Syndrome after Coronary Intervention

作　　者：符史健 Fu Shijian(Department of Cardiology,Haikou Fourth People's Hospital,Haikou 571100,Hainan Province,China)

机构地区：[1]海口市第四人民医院心内科,海南海口571100

出　　处：《中外医药研究》2024年第23期66-68,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:观察老年急性冠状动脉综合征(ACS)患者经皮冠状动脉介入(PCI)治疗后发生氯吡格雷抵抗(CR)对其预后的影响。方法:分析2021年4月—2023年3月于海口市第四人民医院心内科行PCI手术的ACS患者90例的临床资料。所有患者术后均接受硫酸氢氯吡格雷片及阿司匹林治疗。根据患者血小板水平分为抵抗组与非抵抗组,各45例。比较两组患者PCI治疗后心血管不良事件发生率、治疗前后血清炎性因子水平及心功能、治疗后1年再住院率。结果:抵抗组心血管不良事件总发生率高于非抵抗组(P=0.010)。治疗后,两组超敏C反应蛋白、肿瘤坏死因子-α、N-末端B型利钠肽前体水平降低,抵抗组高于非抵抗组(P<0.05)。抵抗组再住院率高于非抵抗组(P=0.019)。结论:老年ACS患者PCI后发生CR可影响其血清炎性因子水平及心功能,增加心血管不良事件发生率和再住院率。Objective:To observe the effect of clopidogrel resistance(CR)on prognosis in elderly patients with acute coronary syndrome(ACS)after percutaneous coronary intervention(PCI).Methods:The clinical data of ninety patients with ACS who underwent PCI surgery in the Department of Cardiology of Haikou Fourth People's Hospital from April 2021 to March 2023 were retrospectively analyzed.All patients received clopidogrel bisulfate tablets and aspirin after surgery.According to the lelvel of platelet,the patients were divided into resistance group and non-resistance group,forty-five cases each.The incidence of cardiovascular adverse events after PCI,serum inflammatory factor levels and cardiac function before and after treatment,and the rate of re-hospitalization 1 year after treatment were compared between the two groups.Results:The total incidence of adverse cardiovascular events in the resistance group was higher than that in the non-resistance group(P=0.010).After treatment,the levels of hypersensitive C-reactive protein,tumor necrosis factor-αand N-terminal B-type natriuretic peptide precursors were decreased in both groups,and those in resistance group were higher than those in non-resistance group(P<0.05).The rate of rehospitalization in resistance group was higher than that in non-resistance group(P=0.019).Conclusion:The occurrence of CR after PCI in elderly patients with ACS can affect the level of serum inflammatory factors and cardiac function,and increase the incidence of cardiovascular adverse events and re-hospitalization.

关 键 词：急性冠状动脉综合征 氯吡格雷抵抗 经皮冠状动脉介入 老年 预后 

分 类 号：R541.4[医药卫生—心血管疾病]